Meta-Analysis on Corneal Changes Following Phacoemulsification in Diabetic vs. Non-Diabetic Cataract Patients

Alotaibi, Faisal; Alosaimi, Rawan Ariman; Alyahya, Fatimah Hassan; Alali, Mohammad Mustafa; Ayidh, Faris Ali Nasser; Alanazi, Farhan Musafiq; Alanizy, Faisal Fahad; Alsaud, Nora Faisal; Himayda, Ahmad Sami A; Albalawi, Nouf; Alsuwailm, Wissam Abdullatif; Alamri, Mohammed Abdullah M

doi:10.12816/0043978

Cited by 2 publications

(1 citation statement)

References 10 publications

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“…However with the introduction of new phacoemulsification systems, cataract surgery has become a safe procedure [12]. New machines combine fewer surges, lower amounts of ultrasound, and more controlled anterior-chamber depth, as wells lower incidence of thermal burns at the incision site [24][25][26].…”

Section: Central Corneal Thicknessmentioning

confidence: 99%

Comparison of Morphological and Functional Corneal Endothelial Changes after Cataract Surgery under DBCS Program at a Tertiary Care Centre

Gupta¹,

Bh²,

Shedole³

2020

J Clin Exp Ophthal

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Introduction: Cataract extraction constitutes the largest workload through DBCS program in ophthalmic units in India. Both SICS & Phacoemulsification surgery are performed in a limited, confined space; however, securing adequate surgical space during cataract surgery can decrease the risk of corneal endothelial cell loss.1 Thus, anatomical and surgical factors, such as adequate Anterior Chamber Depth (ACD), are important for preserving these cells from the mechanical and thermal damage that can occur during the procedure. Under normal circumstances, corneal endothelial cells do not proliferate because they are stuck in G1 phase of cell cycle. The central corneal endothelial cell density gradually decreases at an average of about 0.6% per year, reducing approximately from 3400 cells/mm 2 at age 15 to 2300 cells at age 80 years. Two important factors in maintaining corneal transparency are the number and the integrity of the corneal endothelial cells.3 Corneas with cell densities as low as 500 cells/mm 2 and average cell area of approximately 2000-3000 µm 2 can remain clear. Protection of corneal endothelium during cataract surgery is critical for achieving good visual outcomes. Objectives: To study the endothelial cell loss in SICS and Phacoemulsification and compare the cell loss between two surgeries and to compare morphological and functional changes in corneal endothelium between the two surgeries. Materials and methods: A comparative prospective study is performed in 200 eyes of 200 patients attending DBCS Camp at Babuji Eye Hospital and Chigateri General Hospital attached to JJM Medical College Hospital, Davanagere from July 2018 to October 2019 for cataract surgery. Patients were randomly allocated to two groups. One group underwent small incision cataract surgery and the other group underwent phacoemulsification. Corneal endothelial assessment was done for patients undergoing both the surgeries using non-contact specular microscopy Tomey EM 3000 preoperatively and postoperatively at 1 week and 6 weeks. Results: In SICS group, corneal endothelial count was 2303.0 ± 329.1 preoperatively, postoperatively it was reduced to 2068.9 ± 381.1 at 1 week and 1980.3 ± 401.5 at 6 weeks. In phacoemulsification group, it was found to be 2213.9 ± 442.3 preoperatively and which reduced to 1878.7 ± 458.3 at 1 week and 1796.4 ± 467.3 at 6 weeks postoperatively. Cases in SICS group showed 10.2% loss at 1 week and 14% cell loss at 6 weeks while phacoemulsification group showed 15.1% cell loss at 1 week and 18.9% cell loss at 6 weeks. Polymegathism was increased in both the groups while hexagonality was decreased in both groups. No significant difference in functional parameters like central corneal thickness (CCT) and best corrected visual acuity (BCVA) was observed in both SICS and Phacoemulsification group at the end of 6 weeks.

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Section: Central Corneal Thicknessmentioning

confidence: 99%

Comparison of Morphological and Functional Corneal Endothelial Changes after Cataract Surgery under DBCS Program at a Tertiary Care Centre

Gupta¹,

Bh²,

Shedole³

2020

J Clin Exp Ophthal

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Comparison of corneal changes after phacoemulsification in diabetic and nondiabetic eyes

Elminshawy,

Hegazy,

Aly

2022

Al-Azhar Assiut Medical Journal

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Background and aim Endothelium of the cornea is susceptible to surgical trauma during phacoemulsification from ultrasound energy. Several studies have reported various results of corneal changes after phacoemulsification in diabetic and healthy patients. The aim was to evaluate and compare changes in precorneal tear film, anterior and posterior corneal surfaces, endothelial cell changes, and central corneal thickness (CCT) between diabetic and healthy patients before and after uneventful phacoemulsification. Patients and methods A total of 40 eyes of 40 patients who were scheduled for cataract surgery were divided into group 1 (20 eyes in nondiabetic patients) and group 2 (20 eyes in diabetic patients). Ophthalmological examinations, including uncorrected and best-corrected visual acuity (BCVA), slit lamp to examine anterior and posterior corneal surfaces, tear film breakup time test (TBUT), anterior chamber depth by IOL Master (Topcon ALADDIN HW2.0), and specular microscopy (Topcon SP-1P, made In Japan), were done preoperatively and at 1 week, 1 month, and 3 months postoperatively. Results Significant differences were found between preoperative and postoperative periods in both groups regarding BCVA, TBUT, CCT, endothelial cell density (ECD), coefficient of variation, and hexagonal cells, except that changes became insignificant with respect to CCT at 3 months in nondiabetic and at 1 week and 3 months in diabetic and in CD at 1 month in healthy patients. Conclusion There were significant changes in BCVA, TBUT, CCT, and ECD after phacoemulsification in the diabetic and healthy groups. There was a significant delay in the recovery of CCT 1 month after phacoemulsification in the diabetic compared with healthy individuals.

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Meta-Analysis on Corneal Changes Following Phacoemulsification in Diabetic vs. Non-Diabetic Cataract Patients

Cited by 2 publications

References 10 publications

Comparison of Morphological and Functional Corneal Endothelial Changes after Cataract Surgery under DBCS Program at a Tertiary Care Centre

Comparison of Morphological and Functional Corneal Endothelial Changes after Cataract Surgery under DBCS Program at a Tertiary Care Centre

Comparison of corneal changes after phacoemulsification in diabetic and nondiabetic eyes

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